Zest
Generic Name
Lisinopril
Manufacturer
AstraZeneca (Original brand)
Country
United Kingdom/Sweden
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| zest 6 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Zest (Lisinopril) is an ACE inhibitor used to treat high blood pressure, heart failure, and improve survival after a heart attack. It works by relaxing blood vessels and reducing the workload on the heart.
Uses & Indications
Dosage
Adults
Hypertension: Initial 10 mg once daily; maintenance 20-40 mg once daily. Heart Failure: Initial 2.5-5 mg once daily; maintenance 5-20 mg once daily. Acute MI: Initial 5 mg, followed by 5 mg after 24 hours, then 10 mg after 48 hours, and then 10 mg once daily for 6 weeks.
Elderly
Start with a lower dose (e.g., 2.5-5 mg once daily) due to potential reduced renal function.
Renal_impairment
Dose adjustment required based on creatinine clearance; generally start with a lower dose (e.g., 2.5 mg once daily).
How to Take
Take orally once daily, with or without food. It is recommended to take it at the same time each day.
Mechanism of Action
Lisinopril inhibits the angiotensin-converting enzyme (ACE), which prevents the conversion of angiotensin I to angiotensin II. This leads to decreased vasoconstriction, reduced aldosterone secretion, and lower blood pressure. It also reduces degradation of bradykinin, contributing to its vasodilatory effects.
Pharmacokinetics
Onset
Onset of antihypertensive effect is about 1 hour.
Excretion
Excreted unchanged entirely by the kidneys.
Half life
Effective half-life is approximately 12 hours (due to tight binding to ACE); terminal half-life is about 12.6 hours.
Absorption
Approximately 25-30% of an oral dose is absorbed; bioavailability is not affected by food.
Metabolism
Lisinopril is not metabolized and is excreted unchanged.
Side Effects
Contraindications
- History of angioedema related to previous ACE inhibitor treatment
- Hereditary or idiopathic angioedema
- Concomitant use with aliskiren in patients with diabetes or renal impairment
- Pregnancy (especially 2nd and 3rd trimesters)
Drug Interactions
NSAIDs
May reduce antihypertensive effect and increase risk of renal impairment.
Lithium
Increased serum lithium levels and toxicity.
Aliskiren
Contraindicated in patients with diabetes or renal impairment.
Diuretics
Increased risk of hypotension.
mTOR Inhibitors (e.g., sirolimus, everolimus)
Increased risk of angioedema.
Potassium-sparing diuretics/Potassium supplements
Increased risk of hyperkalemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension. Treatment involves supportive measures, primarily intravenous fluid administration to restore blood pressure.
Pregnancy & Lactation
Contraindicated in the 2nd and 3rd trimesters of pregnancy due to fetal toxicity. Use in the 1st trimester should be avoided if possible. Not recommended during lactation.
Side Effects
Contraindications
- History of angioedema related to previous ACE inhibitor treatment
- Hereditary or idiopathic angioedema
- Concomitant use with aliskiren in patients with diabetes or renal impairment
- Pregnancy (especially 2nd and 3rd trimesters)
Drug Interactions
NSAIDs
May reduce antihypertensive effect and increase risk of renal impairment.
Lithium
Increased serum lithium levels and toxicity.
Aliskiren
Contraindicated in patients with diabetes or renal impairment.
Diuretics
Increased risk of hypotension.
mTOR Inhibitors (e.g., sirolimus, everolimus)
Increased risk of angioedema.
Potassium-sparing diuretics/Potassium supplements
Increased risk of hyperkalemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension. Treatment involves supportive measures, primarily intravenous fluid administration to restore blood pressure.
Pregnancy & Lactation
Contraindicated in the 2nd and 3rd trimesters of pregnancy due to fetal toxicity. Use in the 1st trimester should be avoided if possible. Not recommended during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months, check product specific label.
Availability
Widely available in pharmacies
Approval Status
FDA Approved
Patent Status
Off-patent (generic available)
WHO Essential Medicine
YesClinical Trials
Lisinopril has been extensively studied in numerous clinical trials establishing its efficacy and safety for hypertension, heart failure, and post-MI management.
Lab Monitoring
- Serum creatinine and blood urea nitrogen (BUN) levels
- Serum potassium levels
- Blood pressure
Doctor Notes
- Monitor blood pressure, renal function, and serum potassium regularly.
- Advise patients about the risk of cough and angioedema.
- Caution in patients with bilateral renal artery stenosis.
- Discontinue if pregnancy is detected.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Do not stop taking the medicine abruptly.
- Report any signs of swelling of the face, lips, tongue, or throat immediately.
- Avoid potassium-rich foods or supplements unless advised by your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose.
Driving Precautions
May cause dizziness or lightheadedness, especially at the start of treatment or when changing dose. Exercise caution when driving or operating machinery.
Lifestyle Advice
- Follow a low-sodium diet.
- Engage in regular physical activity.
- Maintain a healthy weight.
- Avoid smoking and excessive alcohol consumption.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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